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Hi all, this definitely applies to me. i wonder if it also applies to those parkies who have the 'reds' problem? janet ------------------------------------------------------ Rosacea ------------------------------------------------------ More Americans Now Enter Danger Years For Rosacea by Mary Erhard With the 77 million baby boomers born between 1946 and 1964 (nearly one in three Americans) now entering the most dangerous years for developing rosacea, the number of adults suffering from this embarrassing and potentially disfiguring disorder of the facial skin is expected to increase in the years ahead. According to a recent National Rosacea Society survey of more than 2,000 rosacea sufferers, 44 percent reported that their symptoms had first appeared in their 30s and 40s, and 43 percent first experienced rosacea after age 50. Now that the oldest members of the baby boom generation are turning 50 and the youngest are 32, they have fully reached the prime years for developing this conspicuous condition that today affects an estimated one in 20 Americans. "While the incidence of rosacea appears to be rising sharply as more people enter the most susceptible age, many mistakenly think it's just a complexion problem that will go away by itself -- but in fact it usually keeps growing worse if left unchecked," said Dr. Joseph Bikowski, assistant clinical professor of dermatology at the University of Pittsburgh. "Of greatest concern is that only a small percentage of rosacea sufferers realize that medical help is available from dermatologists to halt its progression and reverse its symptoms." According to a Gallup survey, only 27 percent of Americans had heard of rosacea. Because of its alarming, acne-like effect on personal appearance, however, it can cause devastating psychological and social problems in addition to its physical effects. What is rosacea, and how does it progress? Now widely believed to be a vascular disorder related to flushing, rosacea may be described in three stages, according to Dr. Mark V. Dahl, professor and chairman, Department of Dermatology, University of Minnesota Medical Center. Although it may first appear as early as the teen years, rosacea most frequently begins when sufferers enter their 30s, 40s or 50s as a flushing or transient redness on the cheeks or nose, and in some cases the chin or forehead. In this earliest stage, some patients may report stinging or burning sensations, including the feeling of dry or tight skin. This can cause "angry face syndrome," Dr. Dahl said, in which almost anything that the patient puts on his or her face stings or burns. Regardless of comfort level during the early stage, tiny visible blood vessels called telangiectasia may eventually appear on the surface of the skin in addition to the subtle redness that may come and go. As rosacea progresses to middle stage, the redness becomes ruddier and more permmanent, and usually occupies a larger area of the face. Bumps, pimples and swelling often develop, and noticeable facial pores later may appear. Swelling sometimes occurs in the cheek area close to the nose, Dr. Dahl noted, resulting in a "baggy cheek" appearance. If left untreated, rosacea may advance to a third stage, in which the spread of excess facial tissue called fibroplasia may develop. In its severe form, this may distort facial features enough to cause what Dr. Dahl describes as "lionization." Red bumps bridge across progressively larger areas of the face, and the nose may become swollen, red and bumpy from excess tissue. This condition, called rhinophyma, gave the late comedian W. C. Fields his famous bulbous nose. In some cases, the eyes may also be affected by rosacea, resulting in a gritty feeling and bloodshot appearance. As the severity advances, the symptoms may include swollen blood vessels in the eyes, and in rare cases small hard bumps may develop on the eyelids and vision may be affected. Rosacea can affect all segments of the population, particularly those with fair skin who tend to flush or blush easily. The disorder may be somewhat more common in women, but is often more severe in men -- perhaps because men tend to delay seeking medical help until the condition reaches advanced stages. People of northern European origin, whose paler skin flushes more easily, appear to be especially vulnerable to rosacea, and the disorder has also been called the "Curse of the Celts." According to another National Rosacea Society survey, 39 percent of more than 300 sufferers who responded had at least one parent of Irish ancestry. In addition, Americans of English, Scottish or eastern European descent were found particularly at risk. While less frequent, rosacea has also been reported in Asian, Hispanic and African Americans. Though rosacea is sometimes referred to as "adult acne," it is a distinctly different and often more serious condition than acne vulgaris, which most commonly occurs during adolescence. While both conditions can cause pimples, rosacea requires different therapy -- acne treatments can actually make it worse -- and rosacea rarely goes away by itself. "For baby boomers in the prime years of their careers, the psychological effects of rosacea can pose particularly severe problems," Dr. Bikowski said. In National Rosacea Society surveys of more than 400 rosacea sufferers, nearly 75 percent said rosacea lowered their self-esteem and self-confidence and 60 percent said it negatively affected their jobs. Sixty percent reported they avoided face-to-face contact because of their condition, and 56 percent said the disease had robbed them of pleasure and happiness. The good news, however, is that 70 percent of the survey respondents reported that their emotional well-being improved following successful medical treatment. Rosacea Review, a newsletter for rosacea sufferers, as well as a broad range of information on rosacea are now available online from the National Rosacea Society at http://www.rosacea.org. People who suspect they may have rosacea can contact the Society via e-mail at [log in to unmask] or call its hotline at (847) 382-8971 to receive general information and issues of Rosacea Review, as well as a list of dermatologists in their areas who are experienced in treating the condition. Information is also available by writing the National Rosacea Society, 800 S. Northwest Highway, Suite 200, Barrington, Illinois 60010. The Society also offers a rosacea tripwires chart and patient diary checklist to help rosacea sufferers identify and avoid those lifestyle factors that may cause flare-ups in individual cases. Rosacea flare-ups can be triggered by an astonishing array of factors, ranging from sun exposure to emotional stress, hot beverages and spicy foods. Lifestyle changes, prescription therapy and, if necessary, laser treatment for visible blood vessels and excess tissue can eradicate rosacea's symptoms. "The key to controlling rosacea is awareness and early intervention," Dr. Bikowski said. "Anyone with possible signs of rosacea should see a dermatologist for diagnosis and appropriate therapy." Editor's note: Mary Erhard is a medical writer for the National Rosacea Society. For additional information on rosacea, go to: http://www.derm-infonet.com/Rosacea.html Rosacea -- AAD Derminfo Net A public service of the American Academy of Dermatology or contact: American Academy of Dermatology 930 N. Meacham Road P.O. Box 4014 Schaumburg, IL 60168-4014 USA Telephone:(847) 330-0230 ------------------------------------------------------------------------- ps i certainly qualify for the pale skinned, flushing and blushing celt stereotype described above. as i grew older, i noticed that an alcoholic drink on an empty stomach would sometimes make my face turn red. and sometimes an early morning cup of coffee would do the same thing. if i stayed outside in the winter in a medium wind for more than half an hour, my face would be red and blotchy for the next day or two, from 'windburn'. after i moved to bermuda, my skin got much worse, [i think from a combination of lots of 'windburn' and the change in climate] i went to a dermatologist, who diagnosed acne rosacea. an acne medication with 5% benzoyl peroxide, used daily for a couple of weeks, was all that was needed to reverse most of the damage. my next major battle with 'the zits' came with the advancement of pd symptoms, before i was officially diagnosed. i developed some severe 'clusters' of acne, which were deep and painful. but when i was diagnosed with pd, the neurologist at that time said that the pd 'slowdown' was the cause of my skin problems, which eventually included some scalp problems as well. i tackled both situations with topical prescription medications, and that treatment, maybe in combination with the sinemet that was also prescribed, seemed to get everything pretty much back under control. i have noticed lately, though, that some 'clusters' have been appearing up on my fore-arms. ..acne on my arms!?!.... what's next? maybe i had these pd-related skin problems to this degree, because i already had a genetic tendency to rosacea. so then i dug these up from: ------------------------------------------------------ An Algorithm For The Management Of Parkinson's Disease =------------------------------------------------------ a supplement of the American Academy of Neurology Reprinted in Neurology 1994;44:S1-S52. Editors: William Koller, M.D. Ph.D Dee Silver, M.D. Abraham Lieberman, M.D. ------------------------------------------------------ SEBORRHEA ------------------------------------------------------ Excessive secretion of oil by sebaceous glands is common in PD. Management. Coal tar shampoos can be used not only for dandruff but also for seborrhea over the eyebrows and forehead. They should not be used more than once or twice weekly. Selenium-based shampoos also work in some patients when used in a similar manner. Topical hydrocortisone is most effective on the face but needs to be applied daily. ------------------------------------------------------ THERMOREGULATION ------------------------------------------------------ The neurochemical and anatomic regulation of temperature is complex and poorly understood. Preoptic and hypothalamic areas appear to have thermoregulatory function. Noradrenergic, serotonergic, and cholinergic systems have an incompletely understood role in thermal homeostatais. Sweating is mediated by efferent sympathetic cholinergic fibers, which may be damaged in PD. Lewy bodies and cell loss in the hypothalamus have been implicated in PD-associated sweating abnormalities. Management. Abnormal sensations of heat or cold, impaired sweating responses, and hypothermia all can occur in the untreated patient. Excessive sweating of the head and neck in response to external heat has been associated with poor heat dissipation. Some of these phenomena disappear with levodopa treatment, which suggests a role for central dopaminergic systems in thermoregulation. Severe drenching sweats occur as an end-of-dose "off" phenomenon in patients with motor fluctuations, further supporting a role for dopamine systems in vasomotor tone and heat regulation. Dopamine agonist therapy may be of benefit to such patients. Although peak-dose chorea can cause sweating, it is rarely if ever as severe as that seen in the "off' state. For patients who experience it, however, a reduction in the dopaminergic medications may help but often at the price of more "off" time. These patients are more likely to respond to beta-adrenergic blockers than are patients with "off"-period sweating. Severe hyperpyrexia after levodopa withdrawal resembles the neureleptic malignant syndrome and needs to be treated promptly with reinstitution of dopaminergic agents. Other causes of excessive sweating must not be neglected simply because the patient has PD. Benign sweating can occur with either a visual, olfactory or gustatory stimulus. Ethanol and aspirin in high doses also can cause increased intermittent sweats. Therefore, taking a thorough history usually will clarify these situations. Thyrotoxicosis and postmenopausal states need to be considered and appropriate endocrine evaluation initiated. Finally, chronic infections such as tuberculosis must not be forgotten in the differential diagnosis. -------------------------------------------------------------- [log in to unmask]